PAR21: LEVALBUTEROL USE IS ASSOCIATED WITH DECREASED HEALTH CARE COSTS IN PATIENTS WITH MORE SEVERE ASTHMA

Abstract

Preliminary pharmacoeconomic analyses suggest that levalbuterol (LEV) therapy is associated with decreased outpatient asthma health care costs. OBJECTIVE: Examine treatment costs in asthma patients stratified by the number of prescribed controller medications (CM), an index of asthma severity. METHODS: Claims data on patients prescribed LEV and RAC were obtained from the PharMetrics Integrated Outcomes Database. Age- and sex-matched samples of patients initiating therapy with LEV or RAC (no prescriptions for either agent in prior 6 months) were selected and their asthma-related charges were assessed over 6 months following the initial prescription. RESULTS: 544 LEV-treated patients were identified and matched to 544 RAC-treated patients. 62% of RAC patients previously received no CM, 20% had 1 CM, and 18% had> 1 CM. Following RAC treatment 30% had 1 CM and 29% had> 1 CM. Use of leukotriene modifiers increased from 8% to 14% and corticosteroid use increased from 33% to 46%. Although LEV patients previously received more CM (41% no CM; 24% 1 CM; 34%> 1 CM), after treatment the percent with> 1 CM declined to 28%. Their leukotriene modifier use increased from 22% to 25% while long-acting bronchodilator use decreased from 13% to 10%. In patients without prior CM, mean charges declined by similar amounts in both groups (LEV: $360, RAC: $306) following treatment. In patients with 1 CM, LEV was associated with a $116 reduction despite a $121 increase in pharmacy charges while RAC was associated with a $22 decrease. In patients with> 1 CM, LEV was associated with a $435 reduction in mean charges while RAC was associated with a $311 increase. CONCLUSIONS: Asthmatic patients treated with LEV required no additional CM and some patients reduced the number of CM. Cost reductions associated with LEV increased with severity.